The Validity and Reliability of a Hybrid Reality Simulator for Wire Navigation in Orthopedic Surgery

Creating training simulators for orthopedic surgery presents unique and largely unexplored engineering challenges. One of these challenges is simulating both the large forces and subtle haptic feedback involved in drilling into bone. This paper involves a hybrid reality wire navigation simulator that combines a physical drill and plastic foam bone surrogate with 3-D graphics to mimic the radiographic imaging often used in a common surgical task. This paper describes experiments to test the simulator's face, content, and construct validity, as well as the precision of the motion-tracking system. The results suggest that the simulator has sufficient face validity to engage trainees and recreates the critical aspects of the wire navigation task. Experimental simulator trials reveal time and accuracy differentials between experts and novices, suggesting construct validity. The results also show that the tracking system is accurate within 3.6 mm.